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General NPI Number Information
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NPI Number | 1699148486
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Entity Type | Individual
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Provider Name | AMBER MARIE JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 11/03/2015
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Last Update Date | 11/03/2015
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Provider Practice Location Address
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Address Line | 15510 1ST AVE. NE
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City | DUVALL
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State | WA
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Zip | 98019
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Country | US
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Telephone | 425-844-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 14308 274TH PL NE
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City | DUVALL
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State | WA
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Zip | 98019-8305
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Country | US
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Telephone | 425-221-0763
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT00003401
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License Number State | WA
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